White House relies on core healthcare team


Peter R. Orszag, the White House official steeped in budget detail, is now so at home in the Capitol that he freely grabs Coke Zeros from the Senate Finance Committee’s private stash when he talks healthcare costs with aides.

Nancy-Ann DeParle, who joined the administration after a career that included running Medicare, is routinely hooked into a nightly 9 o’clock conference call for legislative staff.

And nearly every week, presidential aide Jim Messina eats the same steak-and-fries plate at the same table in the same restaurant with his old boss, Sen. Max Baucus -- the man responsible for the centrist bill that will shape the final healthcare plan.


Months ago, when President Obama made healthcare his top domestic priority and picked the White House team to make it happen, he selected individuals for just this moment -- not for the beginning or the middle of the campaign, but for the end of the fight.

That time has arrived for Obama and for the six people he chose. With deep ties to Capitol Hill, the team is designed for the inside game unfolding now in House and Senate offices. Their job includes gathering intelligence, assessing what lawmakers want and devising compromises to win over balky members without alienating others.

But their paramount goal has been -- and remains -- to keep the process moving irrepressibly forward and on a practicable track. They believe that letting it bog down or veer in some damaging direction, even for a moment, could doom the whole effort.

The core group consists of Chief of Staff Rahm Emanuel, legislative affairs director Phil Schiliro, communications expert Dan Pfeiffer, Orszag, Messina and DeParle. Each brings particular experience and skills to the task. Each is first and foremost an inside player, comfortable operating behind the scenes.

The administration suffered some setbacks because of that focus during the spring and summer, when none of the six took on the role of a public surrogate for Obama.

But the White House survived the early pummeling, and the emphasis on the inside game has paid off more recently.

“The key factor in all major legislation, particularly healthcare, is momentum,” Pfeiffer said. “Healthcare is a boulder: You’re either pushing uphill or downhill. We’ve reached the top, we’re headed downhill now, and we want it to stay that way.”

The mission is changing, however. Where before the focus was on committees, the battle is moving to the House and Senate floor. Now, Obama’s crew will be at the table with lawmakers behind closed doors, crafting compromises to meet attacks from a determined Republican minority and well-financed industry groups.

Obama will play an important role, phoning wavering legislators and trying to coax them to vote yes. But success also hinges on the negotiating savvy of the team.

“All of us are known,” Emanuel said in an interview. “We’ve been through a lot together. We don’t start from scratch, either inside or in dealing with the Senate and House. . . . You’re in a business of relationships: knowing what people can and can’t do, explaining things and [ascertaining] what they care about.”

None of this looks to be easy. The White House wants to pass a healthcare bill with a 60-vote majority in the Senate, which would forestall a filibuster. It is up to Emanuel and company to hit that target.

Though there is ample overlap, each member of Obama’s healthcare team has a different focus. Emanuel oversees the operation. A former congressman from Chicago, he describes himself as a negotiator, but he is also deeply involved in policy, political strategy and communication.

As an illustration of his role, twice over the past month he spoke to union leaders and asked them not to publicly criticize the healthcare legislation advancing in the Senate. He succeeded the first time and was rebuffed the second.

Orszag is the resident budget whiz. A congressional aide recalls watching him page through a fat, dog-eared copy of the U.S. tax code one Sunday in a Senate office, during a conversation about the crucial and politically sensitive question of how to pay for the healthcare plan.

But Orszag’s staff also describes his human side. One night in August he had dinner at a Greek restaurant in Portland, Maine, with Republican Sen. Olympia J. Snowe. He mentioned that he was going to climb New Hampshire’s Mt. Washington the next day. Snowe warned him to be careful, and Orszag, after reaching the summit, sent her an e-mail to assure her he was OK.

When the Senate Finance Committee voted to pass a healthcare bill last week, Snowe was the lone Republican to vote yes.

DeParle, a former healthcare advisor to President Clinton, has embedded herself in the Capitol. When Obama hired DeParle, he told her he wanted her to be the “point guard” of the healthcare team.

The goal seems to be ubiquity -- blanketing Congress with White House aides.

By her count, DeParle has met one-on-one with 135 people, part of a strategy she mapped out with Schiliro.

No one from the team is dictating to Congress. “We’ve been clear on some guardrails. We don’t want to increase the deficit, things like that,” DeParle said. “Otherwise we’ve given them some license to work within their caucuses.”

Both Schiliro and Messina consult with committee chairs to identify wavering members who should get a phone call or personal meeting with the president.

Messina also dispenses political advice, showing up at meetings of senior legislative aides to share poll numbers. The White House message is that if healthcare fails this year, that could spell trouble for Democrats in the 2010 midterm election.

Obama aides point to the Democratic Party’s 1994 midterm losses after Clinton’s healthcare plan collapsed.

“There’s a myth about health reform that came out of 1993-’94: that the Democrats lost the majority because they took on health reform,” said one White House aide, who requested anonymity when discussing the ongoing negotiations. “Our view is that it’s not that they took on health reform. It’s that they didn’t get it done. . . . And when you’re the governing majority and you take on a major issue and you fail, you’re going to pay a political price for that.”

Over the summer, it seemed the Obama plan could fail too. The White House concedes that opponents gained traction by arguing that the proposals amounted to a government takeover of healthcare.

Pfeiffer stepped up his role around that time, seeking to revive some of the aggressive, rapid-response tactics that worked during the 2008 campaign. Just as the old Obama campaign set up websites to “fight the smears,” the White House created Web videos meant to quickly rebut damaging allegations.

“Frankly, we took some lumps in July,” Pfeiffer said.

The White House Six are happier about where they stand now. Last week, at an initial meeting with Senate leaders to discuss merging the various bills, DeParle said the differences did not seem daunting:

“One of the senators present said, ‘Gee, is that all there is? I thought there would be a lot more issues.’ ”




Working behind the scenes


Rahm Emanuel

Chief of staff

The quarterback of the White House campaign, Emanuel oversees policy development, congressional outreach and communications efforts. Emanuel not only has the president’s ear, but also a deep understanding of Congress. A former Chicago-area congressman, he led the Democrats’ successful effort to retake control of the House in 2006. That job required him to learn the dynamics at play in swing districts and moderate districts, many of which are now held by Democratic lawmakers who are wavering on the health legislation.

Jim Messina

Deputy chief of staff

Messina has an almost familial relationship with Sen. Max Baucus (D-Mont.), the chairman of the committee that handled the most important Senate version of the health legislation. His deep knowledge of Congress comes from stints as chief of staff to Baucus and others. Now he gathers intelligence on what lawmakers are thinking about the legislation, which allows the White House to calculate what policy ideas would draw votes to the legislation or drive them away.

Phil Schiliro

Assistant to the

president for legislative affairs

Schiliro also works on outreach to Congress, advising Obama on which lawmakers he needs to meet with or phone. He is a former chief of staff to Rep. Henry A. Waxman (D-Beverly Hills), chairman of the powerful House Energy and Commerce Committee, who has helped him determine which lawmakers need presidential hand-holding.



Director, Office

of Health Reform

DeParle is an expert in health policy and the healthcare economy, having been Medicare and Medicaid administrator under President Clinton and served on the boards of several health industry companies. A Rhodes scholar with a Harvard law degree, DeParle has met one-on-one with 135 members of Congress as part of the health legislation effort.

Dan Pfeiffer

Deputy communications director

A onetime aide to former Sen. Tom Daschle (D-S.D.), Pfeiffer is the media fireman of the health campaign. If a negative story is in the works, he develops a rapid response by talking with specialized media or bloggers. When lawmakers were rocked by tumultuous town halls in August, he helped put the White House on a more aggressive footing, with measures including websites and videos to counter inaccurate information about Democratic healthcare goals.

Peter R. Orszag

Director, Office

of Management

and Budget

The former head of Congress’ budget office, Orszag helps determine the costs and savings of various policy ideas. He also works on the politics of the effort, for example having dinner with pivotal Republican Sen. Olympia J. Snowe in her home state of Maine.


Source: Los Angeles Times